[Quality of life related to health as a factor explaining the use of family medical consultation: a study on the behavioral model]

Abstract

Background: Health services utilization has been studied under several conceptual models. This study is aimed to assess the influence of Health Related Quality of Life (HRQL) on the variability of the primary care consultation utilization under the <<behavioral model>>

Methods: A cross-sectional study. Interviews were conducted with 451 subjects at six health centers in the Community of Madrid. Environmental and individual characteristics (predisposing, enabling and need factors) and HRQL (EuroQol-5D) were collected. Annual visits were retrieved from the computerized clinical history.

Results: Median utilization was 13 visits/year (interquartile range 7-20). HRQL explained 5,2% of utilization variability, living in high-income areas an additional 2.4%, age a 7.4%, incomes a 1.0% and <<need factors>> (chronic illnesses or a hospital admission in the last year) explained an additional 4.1% of the variability. Each increase of the tercile in the perception of HRQL was associated with a decrease of 13,8% of the number of visits/year. Living in high-income areas, and each increase of 1000 in the incomes decreased the percentage of annual visits 17.5 % and 9.5% respectively. Age is associated with an increase of 8.0% of annual visits per decade. Suffering from chronic illnesses or a hospital admission in the last year increased the average number of visits/year to 51.9 and 26.5%.

Conclusions: HRQL is independently associated with the variability of the demand for the family physician after adjusting by << health need>> factors as the <<behavioral model>> proposes.